In the field of education, the portfolio for teaching and learning purposes is frequently implemented. Since the 80's, this methodology has been used in different fields, and in education it started as a teaching-learning tool during the 90´s. The findings suggested that this method be efficient and effective for students, health professionals and teachers, improving the continuing education (Mathers, Challis, Howe & Field, 1999).
In nursing schools we have been implementing this method during the pre-graduate programs and also in nursing master education.
The portfolio also supports learning and assessment of generic competencies: increasing reflective capacity, personal and professional development, verbal and written communication skills, information management skills, critical thinking, and social interaction (Olga Matus, Graciela Torres & Paula Parra, 2009).
The focus of the research is “how do students show the learning evidences in a curricular unit: Núcleo Temático IV - Management of Nursing Care to High-risk Newborns and their Family".?
Methods:
In the Nursing School of Coimbra, the heart of the curriculum in Pediatric Master Program is the portfolio and we designed an exploratory and qualitative study in a way to highlight the most important learning outcomes. We analyzed 16 portfolios during the last four academic years - 2013-2017 and we looked for major evidences synthetized in portfolios.
Results:
The study of a specific clinical situation
Through the clinical case study, students are able to demonstrate their skills to identify and assess the main points of assisting high-risk newborns and their families; prescribe and diagnose the main therapeutic measures and support the high-risk newborn with the identified points, according to the available scientific evidence; Diagnose remedies for the family and intervene to prepared them for the early relationship, bonding, parenting, continual care, as well as grief and loss.
All master students had a case study. Some students produced a very exhaustive report of a clinical child condition. Some standard recommendations about this exercise were given by teachers. Even this, all study cases were very well-defined with support of current and fundamental bibliography. We can see the advantages of a portfolio to describe clinical situations with accuracy and profoundly.
We can point some major nursing diagnosis of the case studies:
- Risk for pressure ulcer in nose and head, by contact with technical devices (prongs, nasal mask, inspiratory circuit and fixation material)
- Impaired sleep
- Potential breastfeeding
- Fear for parents, in a moderate degree, about the fragility of child´s state of health.
- Parent-child bond at risk
- Risk for impaired parenting
- Dyspnea
- Impaired airway clearance
- Dependent food intake;
- Impaired thermoregulation
- Edema in eyelids and feet
- Risk for Impaired Nutritional Intake
- Risk for Infection
- Risk for Hypothermia
Report of the clinical experiences and reflect
With the critical internship report, students are able to reflect upon environmental factors that interfere with the energy and well-being high-risk newborns, their families, and team members; the physical and organizational requirements of an NICU; the maim ethical and legal problems that arise in nursing in NICUs; use scientific evidence in the practice of health care.
The reflection is for students to think back on their studies of the various components of the central theme and the skills they have developed.
The other assignments are evidence of additional learning, which students will be able to use as demonstration of further theoretical-practical development regarding certain specific topics.
All students had much excellent information about the experiences in clinical practice. They put in evidence the meaning of some events and opportunities and they could reflect and engender new ideas, meanings, and vision about future projects in this field.
Some students revealed important changes about personal construction, research capacity, to value the group work, reflect about the practice, the complexity of situations and contexts, to discuss and synthetize clinical data.
These results are coherent and supported by the theories of self-directed learning. The adults are capable of directing their learning, keep internal motivation, have learning needs related to the social roles they wish to adopt, are interested in the immediate application of learning and have a wealth of experiences that can serve as learning resources, (Merriam & Caffarella, 1999, cited by Dias Plasencia, 2016).
Conclusion:
These results confirmed the significance of training which takes as reference all dimensions that contribute to the emancipation, valuing the paradigms that promote the qualification of reflexive nurses, capable to face responsibility for their own training and development.
Having been selected a strategy for guidance and evaluation of learning in the context of clinical teaching, the option for the portfolio has demonstrated to be very significant in student learning, becoming a pedagogic innovation with the consequent search for new practices in the field of education.